Method and apparatus for therapeutic treatment of back pain

ABSTRACT

A therapeutic table construction which isolates a first portion of the patient&#39;s body to a fixed table portion and a second portion of the patient&#39;s body to a moveable table portion, and applies a distraction force to the moveable portion of the patient&#39;s body while positioning the portion of the patient&#39;s spine that is to be treated at an angle so as to isolate the portion of the patient&#39;s spine which receives the distraction force.

CROSS REFERENCE TO RELATED APPLICATION

This application is based upon and claims benefit of copending andco-owned U.S. Provisional Patent Application Ser. No. 60/433,664entitled “Method and Apparatus for Therapeutic Treatment of Back Pain”,filed with the U.S. Patent and Trademark Office on Dec. 16, 2002, by theinventor herein, the specification of which is incorporated herein byreference.

FIELD OF THE INVENTION

The present invention relates to methods and apparatus for the treatmentof back pain, and more particularly to a method and apparatus fortreating lower back pain caused by herniated, bulging, or degenerativedisks, facet syndrome, failed back surgery, or other physiologicaldisorders of the spine.

BACKGROUND OF THE INVENTION

Intervertebral disk injuries and degeneration have long been acontributing factor to lost employee time for a large number ofcompanies. In fact, it is estimated that 80% of the population willexperience severe back pain during their life, while millions live withchronic back pain every day. Excessive loading of the spine throughchanges in a person's lifestyle, extended periods of sitting whiledriving or sitting at a desk, and many other factors all may causepremature degeneration of intervertebral discs and repeated injury ofthe disc annulus.

Often times, treatment of such injuries in an effort to return a personto their livelihood has included conservative treatment modalities thathave provided at best only temporary relief, and as a last resort,invasive surgery that ordinarily carries an associated risk ofparalysis.

Moreover, despite efforts to alleviate back pain symptoms, severelydamaged discs seldom heal. Nutrition in the avascular disc depends onosmotic diffusion of collagen precursors (e.g., proline), nutrients, andoxygen through direct channels in the annulus (30%), and the hyaline endplate in the vertebrae above and below the disc (70%). It is estimatedthat the cycle of proline uptake and renewal in the normal disc(necessary for collagen synthesis and repair) takes approximately 500days. This inherently slow cycle is additionally compromised in thederanged disc. By lowering intradiscal pressures, properly appliedspinal disc decompression therapy (i.e., unloading due to distractionand positioning) would greatly facilitate this process and acceleratehealing in the disc segment.

Mechanical traction has been used in the past in an attempt to alleviatethe pain associated with damaged disc structures, but such methods haveprovided highly inconsistent results. Such mechanical traction involvesthe application of a distracting force to either realign a structuralabnormality or to relieve excessive intradiscal pressures. Successfulmechanical traction can alleviate the pain symptoms associated with suchdisorders. However, prior known methods and apparatus for providingmechanical traction apply the distraction force to the entire spine,thus “treating” areas of the spine that do not exhibit such disorders.Such inefficient application of force to the entire spine structurecarries an increased risk of mechanical traction side effects to normalareas of the spine, such as muscle strain and spasm. It would thereforebe advantageous to provide a method and apparatus for applying adistracting force to a localized area of the spine that requirestreatment, as opposed to the entire spinal column.

Moreover, prior known methods and apparatus for providing mechanicaltraction ordinarily apply harnesses to the patient's upper body portionand pelvis, and pull the pelvic harness so as to apply a traction forceto the patient's spine. Such force application ordinarily requires thata significant amount of frictional force between the patient's body andthe table surface be overcome, as application of the distraction forceswill require relative movement between the patient's body and the tablesurface. Overcoming such frictional forces may cause the forcestransferred from the pulling apparatus to the patient's spine to varyfrom a uniform, linear force application, in turn increasing the risk ofside effects such as muscle spasm and patient discomfort. It wouldtherefore also be advantageous to provide a method and apparatus forapplying a distracting force to a patient's spine while minimizing theoccurrence of non-uniform force application.

Still further, the patient receiving the mechanical traction treatmentoften has no control over the treatment process. This causes anxiety inthe patient, in turn often causing the patient to tense the muscles inhis or her back, which in turn can lead to increased risk of musclespasm. It would therefore also be advantageous to provide a method andapparatus for applying a distracting force while enabling the patient tomaintain a measure of control over the treatment process.

SUMMARY OF THE INVENTION

The present invention provides a method and apparatus for applying auniform, linear distracting force to a localized area of the spine,enables effective distraction treatment with application of a lowerdistraction force than has typically been required, and preferablyenables a patient undergoing treatment to maintain the ability toterminate the treatment without requiring interaction from medicalpersonnel.

The apparatus of the instant invention comprises a therapeutic tableconstruction which, in a first preferred embodiment, isolates the topportion of the patient's body with respect to a fixed upper portion ofthe table, isolates the bottom portion of the patient's body withrespect to a moveable lower portion of the table, and applies adistraction force to the bottom portion of the patient's body whilepositioning the patient's pelvis at an angle so as to isolate theportion of the patient's spine which receives the distraction force. Byaccurately tilting the pelvis during distraction, specific spinalsegments are targeted to enable the precise treatment of a particularlyidentified pathology. This feature eliminates the unnecessary treatmentof additional spinal segments, and any resulting side effects.

In a second preferred embodiment, the apparatus of the instant inventioncomprises a therapeutic table construction which isolates a patient'shead with respect to a moveable head support portion of the table, andisolates the torso portion of the patient's body with respect to a fixedupper portion of the table, and applies a distraction force to thecervical portion of the patient's spine while positioning the patient'shead and neck at an angle so as to isolate the portion of the patient'scervical spine which receives the distraction force. Once again, byaccurately tilting the patient's head and neck during distraction,specific cervical spinal segments are targeted to enable the precisetreatment of a particularly identified pathology, which feature againeliminates the unnecessary treatment of additional spinal segments, andany resulting side effects.

Prior distraction devices have utilized nylon harnesses and straps tosecure the patient's pelvis and upper body to the energy source. Inthese circumstances, energy is absorbed in the several square feet ofnylon fabric and several linear yards of nylon strapping. In addition,energy is dispersed throughout the soft tissues between the harness andthe skeletal structure. The present invention, however, reduces energyloss and absorption by, in a first embodiment, securing the pelvisdirectly, and in a second embodiment, securing the base portion of apatient's skull directly. The elimination of energy loss and absorptionallows for a much lower distraction force, which subsequently reducesside effects such as muscle spasm and patient discomfort.

An infrared heating pad is also preferably integrated with the apparatusthat provides radiating heat at an effective depth of three centimetersto paravertebral tissues during distraction. This warming of tissuesprovides a more relaxed distraction of the spine, and in turn reducesthe incidence of muscle spasm. To further a patient's relaxation duringthe therapeutic process, a CD sound system with wireless headphones ispreferably integrated with the apparatus to provide the patient withrelaxation music throughout the therapy session.

The apparatus also provides both mechanical and electrical,patient-operable, system termination devices. By activation of either ofthose devices, the patient can halt application of force to his or herspine at any time. Thus, treatment is able to proceed without medicalpersonnel in the immediate vicinity of the apparatus. This unsupervisedtreatment allows the device to be placed in a quiet and darkened area toeven further promote relaxation, and perhaps even sleep, for thepatient.

The operation of the therapeutic table is controlled by computersoftware running on a computer processor that is integrated with acontrol unit for the table. To reduce operator error and to maintaintreatment consistency, the device software defines the majority of thetreatment parameters for the operator based on a defined protocol, orwill prompt the operator with a recommended value, which is based onindividual patient data. At the outset of a treatment session, personaldata about the patient is input to the computer software, and based uponthe patient's individual characteristics, an individualized patienttreatment protocol is determined and executed by the software. In orderto reduce the incidence of human error, the table operator is preferablyprompted with a series of default values for each treatment parameterthat is to be entered prior to initiating the treatment regimen. Thepatient data that is input to the software preferably includes thepatient's personal identification data, known pathology related to thetreatment, history of the patient's condition, and previous alternatetreatment undergone for this pathology. The software uses the datastored in an individual patient's data file, such as body weight, tocustomize the treatment for the specific patient. The softwarecalculates every parameter of the treatment, other than the tilt angleof the pelvis or head support. The operator of the device has theability to override the maximum tension applied by the table to ensurepatient-specific tailoring of the treatment. A measure of each patient'spain, disability, and symptoms are collected and attached to thetreatment record to track individual treatment efficacy. Each treatmentbecomes a permanent record stored in a database associated with theprocessor of the control unit.

BRIEF DESCRIPTION OF THE DRAWINGS

Other objects, features, and advantages of the present invention willbecome more apparent from the following detailed description of thepreferred embodiment and certain modifications thereof when takentogether with the accompanying drawings in which:

FIG. 1 is a perspective view of a system for the therapeutic treatmentof back pain according to a first preferred embodiment of the instantinvention.

FIG. 2 a is a left side perspective view of a decompression tableaccording to the embodiment of FIG. 1.

FIG. 2 b is a left side perspective view of the decompression table ofFIG. 2 a showing in phantom the position of a patient lying supine onthe decompression table.

FIG. 3 is a side perspective view of a pelvic restraint system for usewith the table of FIG. 2.

FIGS. 4 a and 4 b are a top and side view, respectively, of elements ofa supplementary pelvic restraint for use with the table of FIG. 2.

FIG. 5 is a top view of an upper body restraint system.

FIG. 6 a is a left side perspective view of a decompression tableaccording to a second preferred embodiment of the instant invention.

FIG. 6 b is a left side perspective view of the decompression table ofFIG. 6 a showing in phantom the position of a patient lying supine onthe decompression table.

FIGS. 7 a and 7 b are a side exploded and front perspective view,respectively, of an alternate rib restraint system for use with thedecompression table of FIG. 6.

FIG. 8 is a cross-sectional view of a knee bolster for use with thetable of FIGS. 2 and 6.

FIG. 9 is an exemplary login screen for use with the method and systemof the instant invention.

FIG. 10 is an exemplary menu screen for use with the method and systemof the instant invention.

FIG. 11 is an exemplary patient data screen for use with the method andsystem of the instant invention.

FIG. 12 is an exemplary treatment control screen for use with the methodand system of the instant invention.

FIG. 13 is an exemplary report control screen for use with the methodand system of the instant invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The invention summarized above and defined by the enumerated claims maybe better understood by referring to the following description, whichshould be read in conjunction with the accompanying drawings in whichlike reference numerals are used for like parts. This description of anembodiment, set out below to enable one to build and use animplementation of the invention, is not intended to limit the enumeratedclaims, but to serve as a particular example thereof. Those skilled inthe art should appreciate that they may readily use the conception andspecific embodiment disclosed as a basis for modifying or designingother methods and systems for carrying out the same purposes of thepresent invention. Those skilled in the art should also realize thatsuch equivalent assemblies do not depart from the spirit and scope ofthe invention in its broadest form.

A preferred embodiment of the apparatus of the instant invention isinitially described with reference to FIG. 1, in which a decompressiontable 10 suitable for applying a distraction force to a targeted portionof a patient's spine is provided in communication with a control unit100.

As shown more particularly in the left side perspective view of FIG. 2,in a first preferred embodiment of the invention, decompression table 10comprises a powered, moveable lower table section 11 and a fixed uppersection 12. Lower table section 11 includes a tilting pelvic support 20that allows tilting of the pelvis during distraction. A pair of pelvicrestraint horns 30 is provided between the upper section and the tiltingpelvic support 20 which are moveable toward and away from one another toadjustably grip against the sides of a patient's body, just above thesuperior iliac crests, when the patient is positioned on thedecompression table 10. A hand crank 31 is provided to allow an operatorto manually adjust the position between facing pelvic restraint horns30.

During use, lower table section 11 is translated away from fixed uppertable section 12 so as to provide a distraction force to the patient'sspine, and is translated back towards upper table section 12 to reduceand/or remove such distraction force. To enable such operation, lowertable section 11 is supported on a sliding rail assembly that isattached to the actuator arm of an electric motor having a linearactuator (not shown). Operation of the motor causes the actuator arm toextend and retract, in turn moving lower table section 11 away from andtoward upper table section 12, respectively. Such drive elements per seare well known in the art.

Tilting pelvic support 20 is moveable preferably in five degreeincrements, such that it may realize an angle of 0°, 5°, 10°, 15°, 20°,and 25°, and thus tilt the patient's pelvis to such degree duringdistraction. The settings required for the angle of the pelvis duringthe distraction are entered into control unit 20 by the system operatorat the start of the treatment session, as explained in greater detailbelow. The particular angle that is to be implemented is determined bythe level of the spine where distraction is intended to occur. Whilecorrelation of particular angles with spinal sections is believed amatter of medical skill, it has been found that the following protocolis particularly useful with the first preferred embodiment describedherein. A setting of 0° tilt angle is useful for applying a distractionforce at L5-S1. A setting of 5° tilt angle is useful for simultaneouslyapplying a distraction force at L5-S1 and at L4-L5. A setting of 10°tilt angle is useful for applying a distraction force at L4-L5. Asetting of 15° tilt angle is useful for simultaneously applying adistraction force at L4-L5 and at L3-L4. A setting of 20° tilt angle isuseful for applying a distraction force at L3-L4. Lastly, a setting of25° tilt angle is useful for applying a distraction force from L2-L3 toL1-L2. In order to achieve the desired tilt angle, a separateelectro-mechanical drive 21 is mounted below pelvic support 20 having anextensible actuating arm 22 which, when extended, pivots pelvic support20 about a pivot 23 on the underside of support 20.

Pelvic restraint horns 30 are adapted to move toward and away from oneanother through manipulation of hand crank 31. As shown in FIG. 3,pelvic restraint horns 30 preferably include a rounded pad 32 mounted toa rigid bracket 33. Located at the bottom of bracket 33 are positioningpins 34 which are configured for insertion into pin holes 35 in sliderblock 36. Slider block 36 is in turn configured to ride along slide rail37 so that facing restraint horns 30 may be moved toward and away fromone another. Preferably, a plurality of sets of pin holes 35 areprovided in each slider block 36 so as to enable the restraint horns tobe mounted in a variety of configurations as may be required forpatients of varying body sizes. Also, pins 34 and pinholes 35 areconfigured to allow restraint horns 30 to easily be removed from sliderblock 36. Thus, the pelvic restraint horns may be removed upon loadingand unloading a patient onto and off of the decompression table 10. Oncea patient is loaded onto the decompression table 10, restraint horns 30are positioned in slider blocks 36 and hand crank 31 is manipulated tobring facing restraint horns 30 towards one another. Hand crank 31 ismounted to an acme screw 38 of traditional design, such that rotation ofhand crank 31 causes slider blocks 36 to linearly translate toward oraway from one another, depending upon the direction of rotation of handcrank 31. The restraint horns 30 and slide rail assembly are sopositioned on decompression table 10 that when restraint horns 30 pressagainst a patient's body, they are positioned immediately above thesuperior iliac crests on both sides of the patient's pelvis. So placed,the restraint horns 30 are then tightened against the sides of thepatient's body via further manipulation of hand crank 31 to securely andcomfortably hold the patient's pelvis to moveable lower table section11. This assembly thus temporarily affixes the lower portion of thepatient's body to moveable lower table section 11, and more particularlyaffixes the patient's pelvis to pelvic support 20.

Optionally, pelvic restraint horns 30 may be provided in varying sizesto ensure comfortable restraint of different sized patients. Moreover,pelvic restraint horns 30 are preferably angled slightly such that thepadded, interior face of each pelvic restraint horn 30 is turnedslightly toward the bottom of table 10 when inserted in each sliderblock 36 so as to better engage a patient's iliac crests and moreefficiently direct a distraction force to the desired portion of thepatient's spine.

It is notable that prior traction systems have utilized a belt orharness separate from a fixed table structure, which belt or harness isstrapped to the patient's pelvis and pulled to apply a distraction forceto the patient's spine. However, by relying on such a configuration, theforces applied to the patient's spine tend to be countered by thefrictional forces between the patient's body and the table surface. Thisin turn complicates the force application and can cause the applicationof non-uniform forces to the patient's spine during the therapeuticsession. Contrastingly, the decompression table of this first embodimentof the instant invention effectively affixes the patient's pelvis to amoveable section of the decompression table 10, such that relativemovement between the patient's pelvis (or other body portions) and thetable 10 need not occur during the application of distraction forces.This allows for greater control and uniformity in applying distractionforces than prior known apparatuses, and likewise reduces the risk ofside effects typically associated with prior known spinal tractiontreatments.

In the event that pelvic restraint horns 30 are unsuitable for aparticular patient (e.g., an extremely obese patient requiringdistraction treatment), a secondary restraint system for the pelvis isoptionally provided for isolating the lower portion of the patient'sbody to lower table section 11, and more particularly for isolating thepatient's pelvis to pelvic support 20. As shown in the top perspectiveview of FIG. 4 a and the left side perspective view of FIG. 4 b, suchsecondary restraint system preferably includes two rigid arms 70 havingat one end thereof a connecting rod 71. Connecting rods 71 areconfigured to slide into a sleeve 74 that is affixed to tilting pelvicsupport 20. Thus, each arm 70 may be easily mounted to and removed fromdecompression table 10. A manually operable set screw 75 is optionallyprovided to temporarily lock each of arms 70 within sleeve 74. Theopposite end of each of arms 70 preferably has a support 72, on which ismounted a buckle 73 for receiving the ends of straps attached to apelvic belt that is strapped to the patient's pelvic region. Byconnecting arms 70 to pivoting pelvic support 20 through sleeve 74, bothpivoting motion and horizontal motion of pivoting pelvic support 20 andlower table section 11 are translated through arms 70 and to buckles 73.Thus, the secondary restraint system moves in unison with the tiltingpelvic support 20 so as to provide angled distraction forces to thepelvis in targeted portions of the patient's spine without requiringrelative movement of the lower portion of the patient's body withrespect to the lower table section 11, as with the pelvic horns 30discussed above.

As shown in FIG. 2, upper table section 12 also includes a manualemergency release lever 15 placed in easy reach of a patient lying ondecompression table 10, and which may be operated by the patient toactivate a mechanical safety release which will disengage an upper bodyrestraint (not shown) attached to mechanical buckle 17. Release lever 15is connected to mechanical buckle 17 via a cable, such that operation ofrelease lever 15 pulls the cable and likewise immediately releases theupper harness from decompression table 10 and eliminates all forceapplication to the patient. Likewise, a patient hand-held electricalswitch 50 is provided which, when activated, signals the controlsoftware to immediately discontinue the treatment session, andeliminates the application of force under a controlled rate of speed.This controlled elimination of force helps to minimize the occurrence ofmuscle spasm. Hand-held switch 50 is configured to be held by thepatient during treatment or clipped to the patient's clothing. Thus,when lying on table 10, a patient is assured that if the treatmentapplies forces which are too excessive or uncomfortable for the patientto bear, the patient may simply terminate the application of thedistraction forces by either releasing the upper body restraint systemfrom fixed upper table portion 12 or terminating movement of lower tablesection 11.

As shown in the top view of FIG. 5, a patient may be secured to fixedupper table portion 12 via an upper trunk stabilization system whichpreferably comprises a fabric harness 85 generally in the shape of aninverted “Y.” Preferably, harness 85 is constructed of nylon fabrichaving an integral foam padding for comfort. The lower, outwardlyextending arms of the harness 85 are configured to capture a patient'sribcage under the lower margin, and are preferably provided ahook-and-loop type fastener 86, such that when the lower, outwardlyextending arms are wrapped around the patient's torso, they may beremovably attached to one another to securely hold the patient. Theupper branch of fabric harness 85 preferably includes two arm straps 87configured to wrap over a patient's shoulders and under their armpits.Straps 87 are thus affixed to harness 85 at two locations so as to forma loop through which the patient's arms are inserted. Straps 87 are alsopreferably adjustable, via a buckle or similarly configured fastener, soas to accommodate patients of varying sizes. For added stability andcomfort, foam padded axilla bolsters 88 are preferably provided at alower end of straps 87 to help distribute the force being applied to thepatient. A preferably nylon connecting strap 89 is also preferablyprovided at the top edge of harness 85, connecting strap 89 beingconfigured for connection to mechanical buckle 17 to isolate thepatient's upper body portion to the upper portion 12 of decompressiontable 10. Harness 85 may thus be released from decompression table 10via operation of the mechanical safety release described in detailabove. In use, a patient is first fitted with harness 85 prior to beingplaced on decompression table 10. Harness 85 is then placed through thepatient's arms much like a jacket. The lower, outwardly extending armsof harness 85 are then positioned across and below the lower margin ofthe patient's ribcage, and then snugly secured. Once the patient ispositioned on decompression table 10, the lower, outwardly extendingarms are readjusted to comfortably secure the ribcage. The axillabolsters are also adjusted using straps 87 so that they fit comfortablywithin the patient's armpit. Connecting strap 89 is then attached to themechanical safety release, and any slack is removed from the strap.

In an alternate embodiment of decompression table 10, a second set ofrestraint horns, configured similarly to pelvic restrain horns 30, maybe provided in upper table section 12 to isolate a patient's upper bodyportion to fixed upper table section 12, instead of a harness.Preferably, such torso restraint horns in upper table section 12 areadapted to move toward and away from one another, and thus are equippedwith a manual operating mechanism like that used to adjust the positionof pelvic restraint horns 30.

As shown more particularly in the side perspective view of FIG. 6, therib restraint horn assembly comprises facing rib restraint horns 52,each preferably comprised of a rounded gel pad mounted to a rigidbracket. As with pelvic restraint horns 30, located at the bottom ofsuch bracket are positioning pins which are configured for insertioninto pin holes in the top face of slider blocks 56. The bottom portionof slider blocks 56 are in turn configured to ride along a side rail 57,again preferably in the form of an acme screw, so that facing ribrestraint horns 52 may be moved toward and away from one another.Preferably, a plurality of sets of pin holes are provided in each sliderblock 56 so as to enable the rib restraint horns 52 to be mounted in avariety of configurations as may be required for patients of varyingbody sizes. Also, as with pelvic restraint horns 30, such pins andpinholes are configured to allow rib restraint horns 52 to easily beremoved from slider block 56. Thus, the rib restraint horns 52 may beremoved upon loading and unloading a patient onto and off of thedecompression table 10. Once a patient is loaded onto the decompressiontable 10, rib restraint horns 52 are positioned in slider blocks 56 andhand crank 51 is manipulated to bring facing restraint horns 52 towardsone another. As mentioned above, slider rail 57 is preferably in theform of an acme screw of traditional design. As hand crank 51 is mountedto slide rail 57, rotation of hand crank 51 causes slider blocks 56 tolinearly translate toward or away from one another, depending upon thedirection of rotation of hand crank 51.

The rib restraint horns 52 and slide rail assembly 57 are so positionedon decompression table 10 that when restraint horns 52 press against apatient's body, they are positioned to capture the lower margin of thepatient's ribcage on both sides of the patient's torso. Moreparticularly, the restraint is formed so that the base of the ribrestraint preferably rests along the 12th rib and captures the end ofthe 11th rib, while the upper end preferably rests on the 10th ribapproximately 2″ from the sternum. The overall length of the paddedrestraint surface is preferably 8¾″ long. Further, the restraint ispreferably positioned at 80 degrees from the horizontal (10 degrees fromvertical), toward the foot end of the table. Through the offset holes inthe restraint receptacle block, the restraints are preferably positionedat 20 degrees counter-clockwise from the parallel line of the length ofthe table. Patient-specific adjustment in relation to distance betweenthe lower margin of the ribcage and the iliac crest is achieved throughpositioning of the rib restraints in the various adjustment pin holes 55in slider blocks 56.

Lateral adjustment of the rib restraints to secure or release the ribsis achieved through the acme screw assembly. Thus, once the patient ispositioned on table 10, rib restraint horns 52 are tightened against thesides of the patient's body via manipulation of hand crank 51 tosecurely and comfortably hold the patient's upper body to upper tablesection 12. This assembly thus temporarily affixes the upper portion ofthe patient's body to fixed upper table section 12.

As with pelvic restraint horns 30, rib restraint horns 52 may beprovided in varying sizes to ensure comfortable restraint of differentsized patients. Moreover, as shown in FIGS. 7 a and 7 b, rigid ribrestraint horns 52 may be replaced with flexible rib restraint straps 52a having facing portions of hook and loop fastening material enablingthe free ends of restraint straps 52 a to be temporarily secured to oneanother so as to wrap around and hold a patient's torso in a fixedposition with respect to fixed upper table section 12. Each restraintstrap 52 a is likewise preferably provided a first hinge member 52 bwhich may be removably connected to a rib harness stanchion 52 c viainsertion of pin 52 d through both stanchion 52 c and first hinge member52 b. As with the bottom of rib restraint horns 52, the rib harnessstanchions 52 c are preferably provided with positioning pins 54 whichare configured for insertion into pin holes 55 in the top face of sliderblocks 56.

Referring again to FIG. 2, also integrated with upper table section 12is an electric infrared heating pad 18 capable of providing deep heat toparavertebral tissues during distraction. While traditional heating padshave been used that provide only topical, conductive heat that onlypenetrates beyond the epidermis (2–3 mm), heating pad 18 is preferablyconfigured to produce radiant heat to depths of 25–35 mm. Heating pad 18is thus capable of relaxing the muscles and the tissue surrounding theregion of the patient's body undergoing treatment by stimulating bloodflow and enhancing circulation. Integrated heating pad 18 thus enablesthe benefit of heat-induced muscle relaxation during the treatmentsession without requiring that a separate heating device be applied tothe patient. Preferably, an operator may disable the integrated heatingpad 18 during the treatment session in the event that the patient isuncomfortable with the heat application. As shown in FIG. 6, infraredheating pad 18 may optionally be integrated with moveable lower tablesection 11, for example rigidly attached to the pelvic restraintassembly, such that the heating pad moves with lower table section 11.

In a second preferred embodiment of the apparatus of the instantinvention, and with particular reference to FIG. 6, the decompressiontable 10 may be provided with a tilting head support (shown generally at200) which is moveable with respect to fixed upper table section 12. Aswith pelvic support 20, tilting head support 200 is supported on asliding rail assembly that is attached to the actuator arm of anelectric motor having a linear actuator. Operation of the motor causesthe actuator arm to extend and retract, in turn moving the tilting headsupport 200 away from and toward fixed upper table section 12. Inaddition to such linear movement with respect to fixed upper tablesection 12, head support 200 is likewise angularly moveable so as toenable the patient's head, and thus the cervical portion of their spine,to be positioned at various angles with respect to fixed upper tablesection 12. As with pelvic support 20, head support 200 is preferablymoveable in specific degree increments, with each specific degree ofelevation corresponding to a particular cervical vertebrae or multiplecervical vertebrae intended to undergo distraction. Again, thecorrelation of particular angles with cervical spinal sections isbelieved a matter of ordinary medical skill. In order to achieve thedesired tilt angle for head support 200, a separate electro-mechanicaldrive is mounted below head support 200 having an extensible arm which,when extended, pivots head support 200 about a pivot on the underside ofhead support 200. The angle of head support 200 may thus be varied inorder to enable horizontal displacement of head support 200 to applydistraction force to specifically targeted discs in the patient'scervical spine.

As particularly shown in FIG. 6, head support 200 is preferably provideda molded concave section 201 shaped to receive the back portion of apatient's head, and is formed from a cushion material so as to maximizethe patient's comfort during use. However, in order to ensure adequateand uniform application of distraction force to the cervical portion ofthe patient's spine, head support 200 is preferably provided a rigidbase member 202 extending vertically above the bottom edge of thecushion in order to provide a rigid support to grip the base of thepatient's skull during application of the distraction force. Straps 203are likewise preferably provided having mating portions of hook and loopfastening material at their ends to wrap around the top portion of thepatient's head and hold it securely to head support 200.

As particularly shown in FIG. 6, both head support 200 and pelvicsupport 20 may optionally be integrated in a single table 10.

Referring again to FIG. 2, both upper and lower sections 12 and 11,respectively, are positioned atop a telescoping elevator base 40allowing the height of the top of the decompression table 10 to beadjusted for varying patients. Telescoping elevator base 40 is in turnmounted atop a frame 45 provided with castors 46 at either end enablingthe entire table 10 to be moved from place to place. A hand-heldelectrical control 60 is preferably provided to enable a table operatorto control the elevation of the decompression table 10. Control 60 ispreferably attached to the table by an electrical cord and has a clipthat is used to store the control on the side of decompression table 10.On the face of the control are controls enabling an operator to vary theelevation of decompression table 10. A handle 47 is preferably affixedto the table for aiding in transporting the table from place to place oncastors 46, and a handle 48 is preferably provided for manually raisingand lowering castors 46.

As shown in FIG. 8, an optional knee bolster 90 may also be provided toelevate the knees during treatment for comfort and stability of thepelvis, and is sized so that it may rest entirely on moveable lowertable section 11 when in use. Preferably, knee bolster 90 is provided inthe form shown in FIG. 8 which provides three separately availableheights for a patient's knees. The cross-sectional view of knee bolster90 of FIG. 8 shows a generally triangular foam pad having a first cornerangle 91 of 50 degrees, a second corner angle 92 of 60 degrees, and athird corner angle 93 of 70 degrees. Each corner angle is preferablyprovided with a rounded corner having a minimum radius of 6 inches, andthe lengths of the sides of the triangle are configured so that theheight of knee bolster 90 may vary from a low setting of at least 12inches, to an intermediate setting of at least 13 inches, to a highsetting of at least 14 inches. Preferably, knee bolster 90 isconstructed of high density foam, and is also preferably covered withmaterial matching the surface of decompression table 10.

Referring again to FIG. 1, control unit 100 includes a programmablecomputer 101 operable with compression table 10 to control theapplication of the distraction force to the patient and the angle ofpelvic support 20. A display unit 102 is preferably provided incommunication with computer 101 to display information pertaining to thepatient, progress of the treatment session, status of decompressiontable 10, and any other information that is pertinent to the treatmentor the apparatus. Display unit 102 may be provided in the form of atouch screen control panel enabling an operator to interface withcomputer 101. Alternately, a computer keyboard, mouse, or other inputdevice may alternately or supplementally be provided. A printer 103 orother output device is also preferably provided for creating a permanentwritten record of a patient's treatment and progress, and other reportsrelating to the function and status of the apparatus described herein. Amodem connection port 104 is also preferably provided to enable remotemonitoring, operation, update, and diagnosis of the system. In the eventof a power failure, an internal battery-backup system (not shown) isalso preferably provided having at least a 30 minute capacity, suchbattery-backup system being capable of continuing the safe operation ofdecompression table 10 to a controlled termination of the currenttreatment session, while emitting an audible warning to notify theoperator of the power failure.

The operation of decompression table 10 is controlled by computersoftware stored on programmable computer 101. Such software controls theoverall treatment process and permanently stores individual patientrecords. A user interacts with the software preferably via atouch-screen interface on display unit 102 (although other input devicesmay obviously be used) to enter data concerning the patient andparameters governing the particular patient's intended treatment.

A user's first interaction with the software requires that a userprovide a login identification so as to prevent unauthorized access tothe software or unauthorized use of the decompression table 10. Arepresentative login screen is depicted in FIG. 9 that prompts a user toinput a unique user identification and password. Assuming that the userinputs a user identification and password that is recognized by thesoftware (i.e., that has previously been stored in a database filelisting authorized users, which database file is accessible byprogrammable computer 101), the user is then presented a menu screen. Arepresentative menu screen is depicted in FIG. 10, and allows the userto access a variety of functions that may be performed by the software.For example, a logout function 131 may log the current operator off ofthe system without a shutdown of the software operating system. Such afunction may be used to change the operator in the event of a shiftchange, or to enable an administrative software function (described ingreater detail below). A patients function 132 may bring up a patientdata screen enabling the operator to input new patient data into thesystem, or modify a current patient's personal data. A treatmentsfunction 133 may bring up a treatment control screen where individualtreatments can be viewed or administered. A reports function 134 maybring up a report control screen which may generate a variety of patientand system reports. An administrative function 135 may bring up anadministrative control screen that enables an administrator to modifyinformation relating to the particular health clinic that operates thesystem. Also, a turn off function 136 may shut down the softwareoperating system through a controlled shut down operation, as is knownin the art.

An exemplary patient data screen 140 is depicted in FIG. 11, and is usedto enter new patient data into the computer, and to modify existingpatient's personal data. When entering new patient data, a user ispreferably prompted to provide the patient's name, address, telephonenumber, date of birth, gender, patient identification number (e.g., apatient's social security number or other unique number), weight, anindication of whether the patient has had previous spinal surgery, thedate of the patient's assessment and first treatment, the length of timethe patient has had symptoms, and the patient's pathology. Preferably,multiple fields are provided in “check-box” format to indicate aparticular patient's pathology, including notations for disc herniation,disc degeneration, and facet syndrome for the specific spinal regions.In the event that data is entered incorrectly (e.g., textual informationis input in a field formatted to receive numeric data), the operatorwill be presented with an error message identifying the data entryerror. Once all of the data has been properly entered, the user may savethe information to store the new patient record in a database associatedwith a processor in programmable computer 101. Also, once the newpatient record has been added and saved, the user may return to the menuscreen (FIG. 10) to select another operation.

While the above description of patient data screen 140 relates to thecreation of a new patient record, such patient data screen 140 may alsobe used to modify information in existing patient records. A user maysimply select a patient in “Select Patient” field 141, at which pointthe software will populate the patient data screen with the particulardata corresponding to the selected patient. The operator may then modifythe information in individual fields on the patient data screen and savesuch changes as described above.

An exemplary treatment control screen 150 is depicted in FIG. 12, andmay be used to enter the treatment parameters for a current treatmentsession and to initiate the treatment. An operator may select a patientthat is to receive treatment from a “pull-down” list of patients storedin the database that is accessed through “Select Patient” field 151.Once a particular patient is selected, the software preferably populatesthe remaining fields with certain default values and calculated valuesbased on the individualized patient's record.

For example, the “Progressive Times” field 152 indicates the number ofcycles that the device will take to ramp up from zero tension to themaximum tension at the beginning of the treatment session. The defaultsetting for “Progressive Times” is preferably 3 cycles.

The “Regressive Times” field 153 indicates the number of cycles that thedevice will take to ramp down from the maximum tension to zero tensionat the end of the treatment session. The default setting for “RegressiveTimes” is preferably 2 cycles.

The “Maximum Tension” field 154 indicates the maximum tension that willbe applied to the patient during the treatment session, and ispreferably calculated by the software as follows. The maximum tensionduring a patient's first treatment session is ¼ of the patient's bodyweight minus 10 pounds. This maximum tension may be gradually increasedbased on the patient's response to treatment, and following a generalguideline of increasing the maximum tension by 3–5 pounds/session.However, as a safety precaution, at no time will the maximum distractiontension exceed 100 pounds. While the system automatically calculates themaximum tension value for the patient's initial treatment, the operatormay modify this value by simply entering the desired value in MaximumTension field 154. The software will accept that value as long as itdoes not exceed the upper threshold of 100 pounds.

The “Hold Time” field 155 is indicative of the time in seconds that themaximum tension will be held during the distraction phase of the cycle,and preferably maintains a default setting of 60 seconds.

The “Relax Time” field 156 is indicative of the time in seconds that theminimum tension will be held during the relaxation phase of the cycle(as described in greater detail below), and preferably maintains adefault setting of 30 seconds.

The “Cycle” field 157 is indicative of the total number of cycles to beadministered during the treatment session, and preferably maintains adefault value of 20 cycles. As each cycle is preferably of 90-secondduration, a total treatment comprising 20 cycles will thus have aduration of 30 minutes. In the event that a treatment session must beinterrupted as it is proceeding and must therefore be restarted, thevalue in “Cycles” field 157 may be modified to resume the treatment forthe remaining period, rather than for an additional 30 minutes.

The “Pain Index” field 158 is a subjective, patient-rated pain levelexperienced by the patient before the treatment session begins and ratedon a scale of 0 to 5 as per a Visual Analogue Scale. The Visual AnalogueScale is a color-coded card having a numerical reference on its reversethat corresponds to the patient's subjective pain index level (0–5). Thepatient is asked to place a point on the line that shows the level oftheir pain before they start the treatment. The operator then measuresthe line with a ruler, and the number marked by the patient is enteredby the operator as data (preferably to one decimal point) in “PainIndex” field 158.

The “Disability Index” field 159 is a subjective, patient-rateddisability level experienced by the patient before the treatment sessionbegins and rated on a scale of 0 to 5 as per the Visual Analogue Scalediscussed above.

The “Comments” field 160 preferably provides a text input area enablingthe operator to record any observations or comments regarding thepatient's response to the treatment as of the day that the currenttreatment session is taking place. Such comments may, for example,include an indication of the success of the treatment, the patient'sresponse to the treatment, and any unusual occurrences during thetreatment.

The “Select Angle” field 161 preferably indicates the angle at whichpelvic support section 20 of lower table section 11 is to be positionedduring the treatment session. The software receives this value onceinput by the operator, and directs the drive unit for pelvic supportsection 20 to change the angle of pelvic support 20 to the angle notedin “Select Angle” field 161. As discussed above, such angle may be setat any 5° step from 0° to 25° to provide localized distraction forces toonly that portion of the patient's spine that is indicated as requiringtreatment.

The “Pause” control 162 is preferably used to pause or interrupt thetreatment session. Initiating this software function will preferablycause the software to direct the appropriate drive mechanism to stopmoving lower table section 11. Initiating this software function again(when the system is paused) will resume the treatment session bydirecting the appropriate drive mechanism to continue moving lower tablesection 11.

The “Cancel” control 163 is preferably used to discontinue orpermanently stop the current treatment session. Preferably, once thecancel function is initiated, the particular treatment session thenunderway is terminated and cannot be resumed.

A check box 164 is preferably provided to enable an operator to selectwhether or not infrared heat pad 18 is to be operational during thetreatment session.

Optionally, an audio device such as a CD player 105 (FIG. 8) may beintegrated with computer processor 101 which, along with a set ofwireless headphones, will enable a patient to listen to soothing music,and thus enhance their relaxation during the treatment session. CDplayer controls 165 may thus also be provided on treatment controlscreen 150 so as to enable the operator to cause the CD player to playmusic during the treatment session.

Preferably, a “Start” function 166 is also accessible from treatmentcontrol screen 150 that instructs the software to begin the treatmentsession. Upon initiating the start function, the software preferablyinitiates a test of electrical safety switch 50 as follows. Immediatelyafter initiating the start function, the software preferably displays amessage to the operator instructing the operator to ask the patient toactivate electrical safety switch 50. When the patient has successfullyactivated switch 50, the software displays a message to the operatorthat the switch is functioning properly, and thereafter initiates thetreatment session.

Also provided on treatment control screen 150 is a trend line graph 170which preferably records the tension applied to the patient over timethroughout the treatment session. The digital image of the trend linegraph is preferably stored in the individual patient data file in thedatabase at the conclusion of the treatment session.

An exemplary reports control screen 180 is depicted in FIG. 13, andpreferably enables an operator to search for, display, and print everypatient's individual treatment session or a summary report of alltreatment sessions administered to the patient. The reports controlscreen 180 preferably includes a first section 181 in which everytreatment in the database for the selected patient may be viewed andprinted, and a second section 182 in which the digital image of thetrend line graph of a selected treatment is displayed. In first section181, a “Select Patient” field 183 enables the operator to select asingle patient whose records are stored in the database. Once anindividual patient is selected, the software populates a treatmenthistory chart 184 providing a listing of each treatment recordassociated with the selected patient. The operator may then select aparticular treatment record, and the software will populate the datafields in “Settings” display 185 with the data that has been saved forthe selected treatment record. Preferably, “Settings” display 185displays “Progressive Times,” “Regressive Times,” “Maximum Tension,”“Hold Time,” “Relax Time,” “Pain Index,” “Disability Index,” “Cycles,”“Angle,” “Heated Pad,” and “Comments” for the selected treatment record.Likewise, second section 182 displays the completed digital trend linegraph for the particularly selected treatment session. Optionally, thesoftware may enable the operator to view the digital trend line graph atdifferent scales via “Zoom” controls 186.

Reports control screen 180 also preferably enables an operator to causethe software to print reports of varying form. A “Daily Progress” reportfunction 187 may be initiated by the operator which will cause thesoftware to print out a summary of every treatment session administeredto the selected patient that is stored in the database. Likewise, a“Treatment” report function 188 may be initiated by the operator whichwill cause the software to print a detailed report of the individualtreatment currently selected, along with a printout of the trend linegraph.

As mentioned above, menu screen 130 also enables an administrativefunction 135 which may bring up an administrative control screen whichenables an administrator to modify information relating to theparticular health clinic that operates the system and default values forvarious treatment parameters. For example, the administrative controlscreen may enable an operator to modify default values for progressivetimes, regressive times, upper limit of maximum tension, automaticcalculation of minimum tension at 50% of maximum up to 50 pounds, lengthof time for maximum force cycle, length of time for minimum force cycle,change the force values from pounds to kilograms, and change thelanguage preference. Access to such administrative control screen isrestricted, such that initiating administrative function 135 will causethe software to query the user for an administration user identificationand password. When the software receives a recognized user name andpassword, it displays the administrative control screen to the user, andenables the user to access the above-noted administrative functions.

A treatment session may thus be carried out as follows. Preferably,prior to loading and setting treatment parameters, the patient is fittedwith the upper harness (shown in FIG. 6). The back of the harness isadjusted so that the lower arms are positioned across and below thelower margin of the ribcage, and then snugly secured. The upper portionof the harness back panel is positioned approximately at the collarlevel of the patient.

Using hand control 60, decompression table 10 is adjusted to the lowestvertical position for comfortable loading of the patient. If the patientwill be uncomfortable from pelvic horns 30 (or for some reason is unableto use decompression table 10 in conjunction with pelvic horns 30), apelvic belt is fitted to the patient's pelvis.

The patient is then led to decompression table 10 and instructed to siton the edge of the table, the height of the table having been adjustedto as to enable the patient to sit on the edge of the table with theminimum amount of back flexion possible. Once the patient is sitting onthe edge of the table, they are instructed to and assisted in bringingtheir legs up onto decompression table 10 so that the patient is in ahalf-sitting position. Once the patient is in the half-sitting position,the operator assists the patient in slowly reclining to a lyingposition.

Once the patient is lying flat on decompression table 10, the patient isslid to a position such that their iliac crests are immediately belowthe position of pelvic horns 30. Once the patient is positioned on thetable surface so that pelvic restraint horns 30 will capture the iliaccrests, the lower arms of the upper body harness (FIG. 6) are readjustedand tightened to comfortably secure the ribcage. The position of theaxilla bolsters are also adjusted so that they fit comfortably withinthe patient's armpit. The connecting strap 89 is then attached to themechanical safety release via buckle 17, and any slack is removed fromstrap 89.

Next, if the secondary pelvic restraint system is being utilized, thepelvic belt is tightened bilaterally around the patient's waist, and theleft and right attachment straps of the pelvic belt are connected to therespective left and right buckles 73 and pulled tight to remove anyslack. If the secondary pelvic restraint system is not being utilized,the appropriate-sized pelvic horns are inserted into their respectiveslider blocks 36 so that they are positioned facing one another. Ifnecessary, the patient is repositioned such that the pelvic horns arepositioned immediately above the iliac crests in the anterior superioraspect. Hand crank 31 is then manipulated to move pelvic horns 30 towardone another and the patient's iliac crests, and tightened to acomfortable but firm tension.

Optionally, knee bolster 90 is positioned under the patient's legs, anda pillow is inserted under the patient's head.

If desired, wireless audio headphones are then placed on the patient sothat the patient may listen to music from audio device 105 during thetreatment session.

The patient is then preferably provided electrical safety switch 50 andadvised of its function and of the function of mechanical safety releaselever 15.

After the patient has been thus situated on decompression table 10, theoperator logs into the system to access the software stored on computerprocessor 101. After the operator has logged into the system, theoperator may enter new patient data if the patient to be treated doesnot yet have a patient record stored in the database, or the operatormay go directly to the treatment control screen 150 (FIG. 12) to enterthe treatment parameters for the particular treatment session. Oncepresented with treatment control screen 150, the operator selects theparticular patient from those listed in the database. The system thenprompts the operator with the Max Tension Value and the angle ofdistraction administered during the last treatment session, which can beadjusted or altered by the operator if necessary. The operator thenenters the patient's pain and disability indexes for the day, treatmentcomments for the day, the angle of distraction (based upon the area ofthe patient's spine requiring treatment), and selects whether or not toactivate the infrared heat pad 18.

If desired by the patient, the operator then initiates audio device 105and causes the software to play music from such audio device 105. Theoperator then causes the software to initiate the treatment session.

At the outset of the treatment session, the software causes a message tobe displayed to the operator instructing them to ask the patient toactivate electrical safety switch 50. Upon proper activation ofelectrical safety switch 50, the software causes a message to bedisplayed to the operator informing the operator that electrical switch50 is functioning properly, and proceeds with the treatment session.

Typical treatment sessions would consist of a series of two force phasesper cycle, which typically consist of a 60 second “Maximum Tension”distraction phase (high force), and a 30 second “Minimum Tension”relaxation phase (low force) over a modifiable number of cycles for anapproximate period of 30 minutes. A graph of this operation would show abeginning force of zero pounds, which is slowly built up to the maximumforce while following a linear curve. The software will graduallyincrease the force tensions to the preset Maximum Tension over aspecific number of cycles, termed the “Progressive Times,” which ispreset at 3 cycles. The maximum and minimum phases in the cycles repeatthrough the treatment session of 30 minutes, and at the end of thesession, force is gradually diminished to zero pounds over the“Regressive Times” period, which is preset at 2 cycles.

After the treatment session is completed, the operator may listadditional comments on treatment control screen 180, and generate anydesired reports for the treatment session.

The invention has been described with references to a preferredembodiment. While specific values, relationships, materials and stepshave been set forth for purposes of describing concepts of theinvention, it will be appreciated by persons skilled in the art thatnumerous variations and/or modifications may be made to the invention asshown in the specific embodiments without departing from the spirit orscope of the basic concepts and operating principles of the invention asbroadly described. It should be recognized that, in the light of theabove teachings, those skilled in the art can modify those specificswithout departing from the invention taught herein. Having now fully setforth the preferred embodiments and certain modifications of the conceptunderlying the present invention, various other embodiments as well ascertain variations and modifications of the embodiments herein shown anddescribed will obviously occur to those skilled in the art upon becomingfamiliar with said underlying concept. It is intended to include allsuch modifications, alternatives and other embodiments insofar as theycome within the scope of the appended claims or equivalents thereof. Itshould be understood, therefore, that the invention may be practicedotherwise than as specifically set forth herein. Consequently, thepresent embodiments are to be considered in all respects as illustrativeand not restrictive.

1. An apparatus for treating back pain comprising: a fixed first bodysupport section positioned on said apparatus so as to lie below an upperbody portion of a patient's body when said patient lies supine on saidapparatus; a moveable second body support section positioned on saidapparatus so as to lie below a lower body portion of said patient's bodywhen said patient lies supine on said apparatus, said moveable secondbody support section being moveable toward and away from said fixedfirst body support section so as to apply a distraction force to saidpatient's spine when said patient lies supine on said apparatus, saidsecond body support section having a pivotable support section connectedwith an electro-mechanical drive, said pivotable support sectionpositioned on said apparatus so as to lie below said patient's pelviswhen said patient lies supine on said apparatus, said pivotable supportsection configured to pivot with respect to the remainder of said secondbody support section about an axis that is perpendicular to alongitudinal axis of said apparatus, said pivotable support sectionangularly displacing in a generally vertical direction so as to tiltsaid patient's pelvis and allow application of distraction forces topredetermined segments of said patient's spine upon movement of saidmoveable second body support section; and a controller, said controllerfurther comprising computer executable code operable to (i) modify theangular orientation of said pivotable support section to isolate adesired region of a patient's spine to receive a distraction force suchthat a distraction force applied to said patient lying supine on saidapparatus in a direction generally parallel to said patient's spine willbe concentrated in said predetermined segments of said patient's spine,and (ii) cause said apparatus to cyclically apply a distraction force tosaid predetermined segments of said patient's spine in a directiongenerally parallel to said patient's spine.
 2. The apparatus fortreating back pain of claim 1, wherein said pivotable support section isconnected with said electro-mechanical drive via an extensible actuatingarm connected to a pivot on said pivotable support section.
 3. Theapparatus for treating back pain of claim 2, wherein said pivotablesupport section is moveable in selected incremental angles.
 4. Theapparatus for treating back pain of claim 1, said fixed first bodysupport section further comprising a pivotable head support positionedon said apparatus so as to lie below a patient's head when said patientlies supine on said apparatus.
 5. The apparatus for treating back painof claim 1, further comprising: a pelvic restraint configured to affixthe pelvis of a patient positioned on said apparatus to said moveablesecond body support section such that movement of said second bodysupport section away from said first body support section causesmovement of said patient's pelvis away from said first body supportsection.
 6. The apparatus for treating back pain of claim 5, said pelvicrestraint further comprising a plurality of pelvic horns moveable towardand away from one another.
 7. The apparatus for treating back pain ofclaim 6, wherein said pelvic horns affix said patient's pelvis to saidpivotable support section.
 8. The apparatus for treating back pain ofclaim 6, wherein said pelvic horns are removable from said apparatus. 9.The apparatus for treating back pain of claim 8, said pelvic hornsfurther comprising attachment means, said apparatus further comprising:a slider block operationally connected to a slide rail; and handoperated adjustment means operationally connected to said slider block,wherein said pelvic horns are attached to said slider block and saidadjustment means enables movement of said pelvic horns toward and awayfrom one another.
 10. The apparatus for treating back pain of claim 9,wherein said attachment means comprises pins on said pelvic horns; andsaid slider block further comprises a plurality of holes for receivingsaid pins.
 11. The apparatus for treating back pain of claim 6, whereinsaid pelvic horns are angled such that the interior face of each suchpelvic horn is turned slightly toward the end of said moveable secondbody support section.
 12. The apparatus for treating back pain of claim6, wherein said pelvic horns are padded.
 13. The apparatus for treatingback pain of claim 6, wherein said pelvic horns are configured toadjustably grip against the side of a patient's body, just above saidpatient's iliac crests, when said patient is positioned on saidapparatus.
 14. The apparatus for treating back pain of claim 1, furthercomprising: a rib restraint configured to prevent movement of a torso ofa patient positioned on said apparatus in the direction of movement ofsaid moveable second section.
 15. The apparatus for treating back painof claim 14, said rib restraint further comprising a plurality of torsoclamping members moveable toward and away from one another.
 16. Theapparatus for treating back pain of claim 15, said torso clampingmembers further comprising rib restraint horns positioned to engage alower margin of a patient's ribcage when said patient lies supine onsaid apparatus.
 17. The apparatus for treating back pain of claim 15,said torso clamping members further comprising flexible straps each ofwhich is pivotably attached to a stanchion to engage a patient's ribcagewhen said patient lies supine on said apparatus.
 18. The apparatus fortreating back pain of claim 1, further comprising an integrated heatingpad.
 19. The apparatus for treating back pain of claim 18, wherein saidheating pad is integrated in said fixed first body support section. 20.The apparatus for treating back pain of claim 1, further comprising asafety mechanism to enable termination of movement of said moveablesecond body support section away from said fixed first body supportsection.
 21. The apparatus for treating back pain of claim 1, furthercomprising a knee bolster.
 22. The apparatus of claim 1, wherein saidpivotable support section is angularly displaced to realize an angle of0°, 5°, 10°, 15°, 20°, and 25° and thus tilt the patient's pelvis tosuch degree during distraction.
 23. A system for treating lower backpain comprising: a table having a fixed first body support sectionpositioned on said table so as to lie below an upper body portion of apatient's body when said patient lies supine on said table, and amoveable second body support section positioned on said table so as tolie below a lower body portion of said patient's body when said patientlies supine on said table, said moveable second body support sectionbeing moveable toward and away from said fixed first body supportsection, said second body support section having a pivotable supportsection connected with an electro-mechanical drive, said pivotablesupport section positioned on said table so as to lie below saidpatient's pelvis when said patient lies supine on said table, saidpivotable support section configured to pivot with respect to theremainder of said second body support section about an axis that isperpendicular to a longitudinal axis of said table, said pivotablesupport section angularly displacing in a generally vertical directionso as to tilt said patient's pelvis and allow application of distractionforces to predetermined segments of said patient's spine upon movementof said moveable second body support section; and a controller, saidcontroller further comprising computer executable code operable to (i)modify the angular orientation of said pivotable support section toisolate a desired region of a patient's spine to receive a distractionforce such that a distraction force applied to said patient lying supineon said table in a direction generally parallel to said patient's spinewill be concentrated in said desired region, and (ii) cause said tableto cyclically apply a distraction force to said desired region of saidpatient's spine in a direction generally parallel to said patient'sspine.
 24. The system of claim 23, wherein said pivotable supportsection is angularly displaced to realize an angle of 0°, 5°, 10°, 15°,20°, and 25° and thus tilt the patient's pelvis to such degree duringdistraction.
 25. The system of claim 23, wherein said table furthercomprises a head support.
 26. The system of claim 23, wherein said tablefurther comprises a knee bolster.
 27. The system of claim 23, whereinsaid controller includes a display unit for interfacing a user of thetable with the computer executable code.
 28. The system of claim 27,wherein the display unit is a touch-screen interface.
 29. An apparatusfor treating back pain, comprising: a fixed first body support sectionpositioned on said apparatus so as to lie below an upper body portion ofa patient's body when said patient lies supine on said apparatus; and amoveable second body support section positioned on said apparatus so asto lie below a lower body portion of said patient's body when saidpatient lies supine on said apparatus, said moveable second body supportsection being moveable toward and away from said fixed first bodysupport section so as to apply a distraction force to said patient'sspine when said patient lies supine on said apparatus, said second bodysupport section having a pivotable support section connected with anelectro-mechanical drive, said pivotable support section positioned onsaid apparatus so as to lie below said patient's pelvis when saidpatient lies supine on said apparatus, the pivotable support sectionconfigured to pivot with respect to the remainder of said second bodysupport section about an axis that is perpendicular to a longitudinalaxis of said apparatus, said pivotable support section angularlydisplacing in a generally vertical direction so as to tilt saidpatient's pelvis and allow application of distraction forces topredetermined segments of said patient's spine upon movement of saidmoveable second body support section, said second body support sectionfurther comprising a pelvic restraint configured for affixing apatient's pelvis to said moveable second body support section such thatmovement of said moveable second body support section away from saidfixed first body support section causes movement of said patient'spelvis away from said fixed first body support section without causingsignificant movement of said patient's pelvis with respect to saidmoveable second body support section, said pelvic restraint furthercomprising a plurality of pelvic horns, each said pelvic horn furthercomprising a base, a bracket extending upwardly from said base, and avertically oriented pad affixed to said bracket and having a concaveface opposite said bracket, said pad being positioned with respect tosaid apparatus such that the concavity of said pad is verticallyoriented and generally faces an interior of said apparatus.
 30. Theapparatus of claim 29, wherein said plurality of pelvic horns areattached to said moveable second body support section so as to move infixed relation therewith and so as to prevent movement of said pelvichorns with respect to said moveable second body support section in adirection parallel to a direction of movement of said moveable secondbody support section.
 31. The apparatus of claim 30, said plurality ofpelvic horns being attached to said moveable second body support sectionso as to be moveable toward and away from one another.
 32. The apparatusof claim 30, said plurality of pelvic horns being removable from saidapparatus.
 33. The apparatus of claim 30, wherein said pelvic horns areangled such that said concave face of each of said pelvic horns isturned slightly toward the end of said moveable second body supportsection.
 34. The apparatus of claim 30, wherein said pelvic horns areconfigured to adjustably grip against a side of a patient's body, justabove said patient's iliac crests, when said patient is positioned onsaid apparatus.
 35. The apparatus of claim 29, further comprising a ribrestraint configured to prevent movement of a torso of a patientpositioned on said apparatus in the direction of movement of saidmoveable second support section.
 36. The apparatus of claim 35, said ribrestraint further comprising a plurality of torso clamping membersmoveable toward and away from one another.
 37. The apparatus of claim36, said torso clamping members further comprising rib restraint hornspositioned to engage a lower margin of a patient's ribcage when saidpatient lies supine on said apparatus.
 38. The apparatus of claim 29,wherein said pivotable support section is angularly displaced to realizean angle of 0°, 5°, 10°, 15°, 20°, and 25° and thus tilt the patient'spelvis to such degree during distraction.
 39. The apparatus of claim 29,further comprising a head support.
 40. The apparatus of claim 29,further comprising a knee bolster.